QUESTIONS AND ANSWERS.pdf

19GE5024R0025 Health Insurance Services for Locally Employed Staff - U.S. Embassy Baku, Azerbaijan

QUESTIONS AND ANSWERS

Q1: We checked the registration on sam.gov.az and find out that there is one registration by the company’s email address. Only registration and no other entries. Should we make any changes or enter some information on samgov.az under the specified email address? Or should we renew our roles and choose options? (contracts, entity compliance, entity registration). How can we see our registration number on sam.gov.az? and where can we find FAR 52.204-7 requirements?

A1: RPSO cannot assist with your sam.gov registration. We provide the following websites for registration information or to contact the help desk for support.

https://sam.gov/content/about/contact https://www.fsd.gov/gsafsd_sp (here you can also create an incident or live chat for support):

Q2: What do you mean by UEI number?

A2: The UEI number is the Unique Entity ID that your company receives once it registers on sam.gov.

Q3: C.1.1.18 section- transportation costs during treatment abroad are paid by the insured person. Do we understand correctly that if it is impossible to carry out such treatment on the territory of the Azerbaijan Republic, the insured person should be reimbursed 80% of the cost of the trip to this place in the cheapest way?

A3: Correct.

Q4: C.1.1.20 section- By paying an additional insurance premium in the amount of 100% of the insurance premium, it is planned to receive additional insurance in the amount of 60 000 US dollars. Due to this, the application is only accepted when the contract (or the next one-year contract period) begins? Should the same application be accepted by the Insurance Company if the sum insured is exhausted during the term of the contract and during any annual period thereof?

A4: Excess coverage can be selected by individual employees and will provide them with an additional USD 60,000 coverage. Employees can add it at any time (at the prorated coverage based on the time left in the contract year, at a reduced premium rate).

Q5: According to current legislation, the insurance plan lists only those diseases that are subject to free treatment in specialized public medical institutions (for example, tuberculosis). Is it https://sam.gov/content/home https://sam.gov/content/about/contact https://www.fsd.gov/gsafsd_sp permissible for the insurance company to refuse treatment on this basis? In this case, is the insurance company obliged to pay for treatment abroad?

A5: Since the Embassy does not contribute to the local social security system and our staff do not have access to public medical institutions, the insurance company should cover expenses in private clinics where the treatment is available. If the treatment is not available locally, then the expenses for the treatment obtained abroad should be covered by the insurance company including travel expenses.

Q6: The document reflecting the gender and age of employees mentions only employees who will be insured under the “Self Only” and “Family” (three or more persons) insurance plans, and the price list also indicates employees who are insured under the “Self Plus One” insurance program. (two individuals). Please provide information about these employees. In addition, could you please provide information about family members in the format provided for employees -gender, age, insurance plan (Self Plus One or Family), and the number of family members for each employee who has chosen the Family Insurance Plan.

A6: See Attachment V - Employees & dependents data April 25, 2024.

Q7: The list provided contains information about 331 employees, however, the number of employees in the price list is 337 people. Could you please advise on the basis of which information the price list will be filled out.

A7: Your price offer should be based on quantities listed in Attachment I - Price schedule_updated March 18 2024. Note that, as per provision 52.216-21 - Requirements (Oct 1995), the quantities of supplies or services specified in the Schedule are estimates only. The number of the Embassy employees is not a constant and can change. For information purposes only, as of April 25, 2024 the number of employees is 327.

Q8: During the Base Year of the contract, and during the option year that might be exercised, the United States Government (USG) shall place orders totaling a minimum of $5,000.00. This reflects the contract minimum guarantee for each period of performance. The amount of all orders, for base and all option years shall not exceed *to be added at the time of award. This reflects the contract maximum – please clarify.

A8: As per provision 52.216-21 - Requirements (Oct 1995), the quantities of supplies or services specified in the Schedule are estimates only. The Government does not guarantee that these quantities will be ordered. The minimum guaranteed order amount is $5,000.00 (or equivalent in offer currency). The maximum contract amount requirement has been removed from the solicitation.

B.5 has been amended as follows:

B.5. MINIMUM AMOUNTS

During the Base Year of the contract, and during the option year that might be exercised, the United States Government (USG) shall place orders totaling a minimum of $5,000.00. This reflects the contract minimum guarantee for each period of performance.

Q9: Are there comments allowed when listing services in technical proposal?

A9: Comments are allowed.

Q10: Is our understanding correct – we may apply only your Exclusion list to this contract?

A10: Yes, for exclusions refer to the list in the solicitation (see C.1.3 EXCLUSIONS AND

LIMITATIONS).

Q11: Is loss history available?

A11: See Attachment VI - Loss data for vendors 04-25-2024.

Q12: Should we show fixed premium for all years? If so, will we be able to adjust it for renewal upwards/downwards?

A12: A price offer is required for the base and all four option years. Adjustments to the price offer can be made as detailed in paragraph B.7. ECONOMIC PRICE ADJUSTMENT-HEALTH

INSURANCE PREMIUMS.

Q13: Is our understanding correct – sum insured per person per year is 60 000 USD?

A13: Correct, the annual maximum is USD 60,000 per insured person. Additional coverage equal to USD $60,000 per covered individual per contract year in case of Catastrophic Condition (see C.1.1.16. Catastrophic Coverage). Also, Excess Coverage can be purchased by employees - Additional coverage equal to USD $60,000 per covered individual per contract year (C.1.1.20.

Excess Coverage).

Q14: Immunizations – does it imply any vaccine for trip?

A14: All Immunization recommended by local Health authorities and/or the World Health Organization is covered.

Q15: Medicine – should bioactive food supplements, medicines not licensed by Health Ministry be included?

A15: All medication prescribed by a licensed Health provider for the purpose of prevention or management of disease is covered.

Q16: Hearing aids – applicable cap/Optical care – annual cap. Please clarify.

A16: Prescription lenses and frames, or contact lenses: Covered up to a maximum of USD300 per covered individual every two years. 80% Minimum Coverage; with annual cap. For example:

Employee buys lenses which cost USD500, 80% of this amount is USD400. Since there is a cap you will reimburse him only USD300. Next time the employee can buy lenses only in two years.

However, other expenses related to optical care does not have cap (limits) and 80% of expenses should be reimbursed. In this case only overall annual maximum limit of USD60,000 should be taken into account unless Excess Coverage of additional 60,000 also purchased, then total annual maximum should be taken into account and it will be USD120,000. Also see C.1.1.16.

Catastrophic Coverage if the treatment is a result of as a result of a single/illness/accident or closely related set of major illnesses (or conditions relating to a single accident).

Q17: C.1.1.17. Out-of-Country Medical Treatment: Medical expenses incurred out-of-country will be covered at the same benefit levels and subject to the same total maximum annual limit as for medical expenses incurred in-country. – is our understanding correct – Insurance company reimburses expenses incurred within average amount this case would’ve cost in Azerbaijan?

A17: No, this is not correct. Reimbursements for expenses abroad should be based on the actual cost for the services, medicine etc.

Q18: C.1.6.5. No PII information will be included in the report. a. Employee Claims Report. The report will list all claims paid by the Contractor to a claimant, including the name of the claimant, date claim is received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of why claim has not been paid – would’ve appreciated your clarification on this - it says “No PII information” and “name of the claimant” comes right after. In “Strategic Plan” there is a requirement for a format a report will be provided

at. This data is deemed sensitive and any disclosure of names is a breach of confidentiality.

Would’ve appreciated your comment on that.

A.18: Please provide the report in the format requested in section C.1.6.5. PII stands for personal identification information, therefore there is no need to provide information other than identified in this section.

Q19: Past Performance İnformation – Due to volume of insurance portfolio, we won’t be able to provide all references for recent contracts, however, a list of top 10 clients and some reference letters will be provided. Also, Due to article 6 of “Law of Insurance Practice of Azerbaijan Republic about”, information required by item “a” may not be disclosed.

A19: Past Performance İnformation requirement has been amended and now requires offerors to submit maximum 5 recent and relevant references. References are accepted without part of the requested information when such information cannot be disclosed due to legal or proprietary reasons.

Q20: Section K (pages 37-55) - there are items that can be hardly/not related at all to provision of medical insurance services. Is it acceptable to skip some questions?

A20: Offerors are required to fill in Section K.

Q21: A completed solicitation, which includes the SF-1449 cover page blocks 12, 17 and 30 as appropriate, plus any SF 30’s (Amendments) if any filled-in – where are these forms?

A21: SF-1449 is the first page of the solicitation document. Blocks are numbered. For example, block 30:

Q22: Strategic Plan – claims workflow system and timeframes – should we describe the way claims are handled and settled?

A22: Yes, offerors have to provide details.

Q23: Strategic Plan – section m – Certificate of Insurance. This point is a bit confusing for us, because as an Insurance Company we do have a license which we surely will submit. Will that be sufficient?

A23: Yes. However, if you have any additional certificate(s) which demonstrates that your risk are reinsured, please provide.

A24: Strategic Plan, section e. – What is implied under a “pool”? Should it be monetary figure showing solvency of a company and ability to pay for claims? (it is stipulated in section “i”).

A24: Yes.

A25: Annual letter of tax clearance – this document is being provided by Ministry of Finance and it is in Azerbaijani. If translated in English, should it be notarized? Should we also notarize a license?

A25: Yes, it should be translated and notarized.

Q24: Management Plan – sections d thru e – please clarify.

A24: For d) offerors will need to provide proof that they are authorized to operate and do business in Azerbaijan;

For e) if applicable, offerors will need to provide:

1) If the offeror has checked (i) in provision K.1 - Contractor Recruitment of Third Country Nationals, provide a Recruitment Plan and a Housing Plan

2) If the offeror has checked (ii) in provision K.1 - Contractor Recruitment of Third Country Nationals, provide a Recruitment Plan

See C.1.12 - RECRUITMENT OF THIRD COUNTRY NATIONALS FOR PERFORMANCE ON DEPARTMENT OF STATE CONTRACTS (MAY 2023) (page 17 of the solicitation for details).

Q25: Currency – USD, correct?

A25: It is not mandated that the offer be in USD. Companies need to state the currency of their offer. See B.4.3. Pricing Summary.

Q26: As for price schedule, would’ve appreciated your comment on a way it should be operated.

A26: Companies are required to fill in excel file “Attachment I - Price schedule_updated March 18 2024”. The file calculates automatically yearly totals based on the monthly price quote. Insert your monthly price quote “Rate per month” (for self only/ self plus one/ family):

Q27: “The recruitment of Third Country Nationals (TCNs)” – if we don’t plan to recruitment TCN, should we send Recruitment Plan anyway?

A27: If your company does not plan to recruit TCNs for this contract, mark section K.1 accordingly, with “does not intend”. A recruitment plan is not required in this case.

Q28: Please send us loss history for the last 5 years.

A28: See Attachment VI - Loss data for vendors 04-25-2024.

Q29: We would’ve appreciated if you provide number of employees and family members separately and also total number of persons to be insured.

A29: For information purposes only, as of 04/25/2024 Number of employees– 327, family members – 660, total - 987. Use Attachment I – Price schedule for providing your quote.

Q30: Attachment II, number “124” appears at the end of “Self-only” list, whereas actual it comes to 40 (42 in price schedule) – kindly request clarification on this.

A30: See Attachment V - Employees & dependents data April 25, 2024. Use Attachment I – Price schedule for providing your quote.

Q31: In the family plan list there is a person aged “2” – please confirm.

A31: See Attachment V - Employees & dependents data April 25, 2024.

Q32: Annual physical examination – please provide a scope.

A32: The scope of annual physical examination shall comply with local practice. However, annual physical examination should complement the Preventive and Wellness Services and Chronic Disease Management benefit and should serve the purpose of disease prevention and management.

Q33: Preventive and Wellness Services and Chronic Disease Management – does it imply care in sanatorium?

A33: Yes, Preventive care is designed to prevent or detect medical conditions and care for chronic conditions such as asthma and diabetes, cancer etc. Therefore, all physicals, immunization, diagnostic test/diagnostic imaging; for example cancer screenings, prescribed by a licensed health provider for the purpose of detecting, prevention or management of chronic disease is covered.

Q34: Prenatal care – does it imply coverage for ART pregnancy as well, since ART is listed under Exclusions?

A34: Prescribed contraceptive devices, preventive care, routine exams, voluntary sterilization, diagnosis and treatment of conditions which may cause infertility. Assisted reproductive technology (ART), fertility treatments, reversal of sterilization are NOT covered (see Exclusions to Coverage). The ART process is not covered, however any care related to the resultant pregnancy would be covered.

Q35: Catastrophic coverage – had there been incidents under this coverage for the last 5 years?

A35: This is a new coverage. The Government does not have past data.

Q36: We need assistance with SAM registration.

A36: See A1.

Q37: Excess Coverage – will Insured persons buy the option at the beginning of the contract, or at any time when his/her annual maximum limit is exceeded?

A37: Excess coverage can be selected by individual employees and will provide them with an additional USD 60,000 coverage. Employees can add it at any time (at the prorated coverage based on the time left in the option year, at a reduced premium rate).